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Review
. 2018 Apr;25(3):374-393.
doi: 10.1177/1073191117721740. Epub 2017 Jul 26.

Assessment of Somatization and Medically Unexplained Symptoms in Later Life

T J W van Driel  1 , P H Hilderink  1 , D J C Hanssen  2 , P de Boer  1 , J G M Rosmalen  3 , R C Oude Voshaar  3
Affiliations
Review

Assessment of Somatization and Medically Unexplained Symptoms in Later Life

T J W van Driel et al. Assessment. 2018 Apr.

Abstract

The assessment of medically unexplained symptoms and "somatic symptom disorders" in older adults is challenging due to somatic multimorbidity, which threatens the validity of somatization questionnaires. In a systematic review study, the Patient Health Questionnaire-15 (PHQ-15) and the somatization subscale of the Symptom Checklist 90-item version (SCL-90 SOM) are recommended out of 40 questionnaires for usage in large-scale studies. While both scales measure physical symptoms which in younger persons often refer to unexplained symptoms, in older persons, these symptoms may originate from somatic diseases. Using empirical data, we show that PHQ-15 and SCL-90 SOM among older patients correlate with proxies of somatization as with somatic disease burden. Updating the previous systematic review, revealed six additional questionnaires. Cross-validation studies are needed as none of 46 identified scales met the criteria of suitability for an older population. Nonetheless, specific recommendations can be made for studying older persons, namely the SCL-90 SOM and PHQ-15 for population-based studies, the Freiburg Complaint List and somatization subscale of the Brief Symptom Inventory 53-item version for studies in primary care, and finally the Schedule for Evaluating Persistent Symptoms and Somatic Symptom Experiences Questionnaire for monitoring treatment studies.

Keywords: MUS; aged; aged 80 years and older; instruments; medically unexplained symptoms; somatic symptom disorders; somatic symptoms; somatoform disorders.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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